Individual
MR. MICHAEL S GORDON
Active
Individual
MR. MICHAEL S GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA05912000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050071446
RAIL ROAD MEDICARE
NJ
01
—
0658805000
AMERIHEALTH PRODUCTS
NJ
01
—
1097352
HORIZON MERCY
NJ
05
—
5531802
—
NJ
Enumeration date
10/03/2005
Last updated
11/16/2011
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